To request a review for a rejected psychiatric injury claim or psychological injury claim, you must lodge a formal application with the Workers’ Compensation Regulator using Form 542.3, known as an Application for Claim Review.
How to Structure Your Request
The most important part of your application is stating your “grounds for review”. This is your opportunity to explain why WorkCover Queensland’s decision was incorrect, based on the facts, the medical evidence and the law.
1. Challenge their findings on “a significant contributing factor”:
If the insurer claims work wasn’t a significant factor, outline in your submissions which of the evidence clearly shows that your employment was a significant contributing factor to your injury.
2. Challenge their findings on “reasonable management action”
If your claim was rejected under Section 32(5), you must argue that the management action was not reasonable or was not taken in a reasonable way.
Identify any procedural failures. Mention if you weren’t given prior warnings of a meeting, were denied a support person, or if the tone or approach used by management was aggressive or intimidating. Mention if the employer did not follow it’s own procedures.
3. Provide New or Supporting Evidence
Provide further evidence, if possible, of specific stressors like bullying, harassment or an excessive workload.
The Regulator will only consider what you submit; they generally do not conduct new investigations. Where possible, include things like:
- Supplementary Medical Reports: A letter from your treating psychologist or psychiatrist specifically responding to the insurer’s reasons for rejection.
- Factual Documentation: Emails, witness statements, text messages or diary entries that contradict the employer’s version of events.
4. Request a “Right of Appearance”
On the application form, you can elect a “Right of Appearance”. This allows you to speak directly with the Review Officer—either in person or over the phone—to highlight the key evidence supporting your case and for them to ask any questions where appropriate.
Important: Strict Deadlines
You only have three (3) months from the date you receive WorkCover Queensland’s decision to lodge an Application for Claim Review with the Workers’ Compensation Regulator. The Regulator then theoretically has around 7 weeks to notify you in writing of their Review Decision but in practice it often takes much longer than that.
